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Keep Moving to Prevent and Relieve Back Pain

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Keep Moving to Prevent and Relieve Back Pain KEEP MOVING TO PREVENT AND RELIEVE BACK PAIN Presented by: DR. ABEL NEGRETE, MD NATIONAL ACADEMY OF OSTEOPATHY TORONTO, ONTARIO JUNE, 2011 GLOSSARY Pag. BACK ANATOMY 4 MUSKULOSKELETAL INJURY 5 WHAT CAUSES ACUTE BACK PAIN? 6 KEEP MOVING TO PREVENT AND RELIEVE BACK PAIN 7 EXERCISE 8 WHY IS EXERCISE GOOD FOR THE SPINE? 9 EXERCISES FOR THE SPINE 10 LIFTING TECHNIQUES 12 HELPFUL DOS AND DON´TS 14 TREATMENT OPTIONS 16 PREVENTING RE-INJURY 18 HOW TO AVOID GIVING UP? 20 BACK ANATOMY Men and women are equally affected by lower back pain, and most back pain occurs between the ages of 25 and 60. However, no age is completely immune. Approximately 12% to 26% of children and adolescents suffer from low back pain. Fortunately most low back pain is acute, and will resolve itself in three days to six weeks with or without treatment. If pain and symptoms persist for longer than 3 months to a year, the condition is considered chronic. Humans are born with 33 separate vertebrae. By adulthood, most have only 24, due to the fusion of the vertebrae in certain parts of the spine during normal development. The lumbar spine consists of 5 vertebrae called L1 through -L5. Below the lumbar spine, nine vertebrae at the base of the spine grow together. Five form the triangular bone called the sacrum. The two dimples in most everyone's back (historically known as the "dimples of Venus") are where the sacrum joins the hipbones, called the sacroiliac joint. The lowest four vertebrae form the tailbone or coccyx. The anatomy of the spinal column is extremely well designed to serve many functions. All of the elements of the spinal column and vertebrae serve the purpose of protecting the spinal cord, which provides communication to the brain, mobility and sensation in the body through the complex interaction of bones, ligaments and muscle structures of the back and the nerves that surround it. The back is also the powerhouse for the entire body, supporting our trunks and making all of the movements of our head, arms, and legs possible. Almost everyone experiences acute back pain at some point in their life. Most sudden attacks of acute back pain are the result of overstretched muscles (strains) or ligaments (sprains). The pain may be most severe immediately after injury, or it may worsen gradually over a few hours. In most instances, back pain as a result of strain or sprain can be resolved following a conservative course of treatment—usually within two to six weeks—provided there are no serious underlying medical conditions. Identifying the cause of the pain, alleviating the pain— either at home or with physician's help—and avoiding re- injury are key to the healing process. MUSKULOSKELETAL INJURY Back pain is most likely to occur when the muscles in the back are not up to the task of protecting the spine. This can happen because a person is out of shape, fatigued or when they subject their back to sudden forces or heavy loads. For the lower thoracic and lumbar spinal regions the most important muscle groups are: Quadratus Lumborum Originates from the last rib (12th) and transverse processes of L1-L4 and inserts at the iliac crest. Psoas Iliacum Composed of the psoas major and the iliacus. Psoas Major Origins at the transverse processes and vertebral bodies of T12-L5 and insertions at the lesser trochanter of the femur. Iliacus Originates at the anterior margin of the iliac crest and inserts at the lesser trochanter of the femur. Muscle spasms usually signal irritation of the lower back, and often the injury can be treated conservatively with rest, ice and over-the-counter pain medicine. Muscle spasms are a reaction to both muscle injury and ligament injury, so it can be hard to differentiate at first. When there is a musculoskeletal injury, most often the muscle is torn to some degree. Because the muscles in the body have ample blood supply, they usually repair quickly and easily within a few days. Muscle injuries often induce swelling to prevent further movement that could cause more injury. When muscles cease to move, they eventually atrophy and weaken, so it's important to get the swelling down as soon as possible, so you can begin to move the injured muscle more quickly. Treatment for a musculoskeletal injury with accompanying inflammation calls for ice to reduce the swelling and to relieve the spasm. WHAT CAUSES ACUTE BACK PAIN? Common causes of strains and sprains that can trigger acute back pain include: Improper lifting Sudden, strenuous physical effort Accident, sports injury or fall Sleeping position and/or pillow positioning Poor sitting or standing posture Bending forward too long "Hiking" your shoulder to hold the phone receiver to your ear Carrying a heavy purse, briefcase or backpack Stress and muscle tension Physical conditions that can possibly contribute to the onset of acute back pain include: Lack of muscle tone Excess weight Pregnancy Most back pain develops suddenly after lifting a heavy object or spraining the muscles in the back during vigorous exercise. Another common cause of back pain is poor posture at work or during prolonged periods of sitting. This type of back pain is often the result of the muscles that support the spinal column becoming weaker over time. Doctors refer to this type of weakness as "deconditioning" which describes the body's natural response to inactivity and little exercise. As the muscles that support the spine and trunk become weaker, they are less able to withstand heavy lifting, or support the spine in its normal position, and as a result, the entire back becomes sore and tired. Exercise is the best way to prevent this type of pain from occurring. Several studies have shown that regular cardiovascular exercise, like swimming, bicycling, jogging, or hiking, is the most beneficial form of exercise for treating and preventing back pain. This type of exercise, which promotes good health in general, has been shown to be as effective as nearly every other type of physical therapy program or exercise regime. In addition, this is the type of exercise that is easy to do, enjoyable, and definitely good for everyone. KEEP MOVING TO PREVENT AND RELIEVE BACK PAIN The spinal column is one of the most vital parts of the human body, supporting our trunks and making all of our movements possible. When the spine is injured and its function is impaired the consequences can be painful and even disabling. According to estimates, 80 percent of Americans will experience low back pain at least once in their lifetime. A small number of patients will develop chronic or degenerative spinal disorders that can be disabling. If you have troubling symptoms, such as back pain, you aren't alone. Between 75 and 85% of all people will experience some form of back pain during their lifetime. In fact, back pain is the second most frequently reported reason for visiting a doctor, and after the common cold, is the next leading reason for missed workdays for people under 45. These are some common symptoms: Back Pain Acute Back Pain (short-term back pain) Chronic Back Pain (long-term back pain) Radiating Pain/Sciatica Numbness and Weakness Stiffness and Tightness Bowel and Bladder Dysfunction EXERCISE Regular exercise is an essential part of having a healthy back. In the treatment of back pain, manual osteopaths and every other healthcare provider agree that exercise plays an important role in recovery. Every day we make demands on our bodies that can stress our backs. It's a well known fact that the more fit you are, and the stronger your back is, the more easily your body can deal with the stress and strain of every day activity. Unfortunately, when most people start to experience back pain, they become less active. As a result, the muscles that support the spinal column become weaker and have less endurance. If your back loses enough muscle tone, the muscles can shrink, contract and tighten. Your back may feel tight much of the time, tire easily, and start to feel uncomfortable even when you are sitting in a chair. The feelings associated with chronic back pain and spinal fatigue, make most people feel drained, tired and depressed. It becomes harder and harder to break the cycle of pain causing inactivity, which causes more pain, which then causes more inactivity. Eventually, this scenario can lead to other health problems that are the direct result of inactivity, such as heart attacks, strokes and obesity. Therefore, exercise is an important part of the "use it or lose it" theory of overall spine health. Patients with chronic low back pain are particularly susceptible to suffering from the ill effects of too little exercise. If it hurts when you move your back, and is less uncomfortable when you don't, then you have the perfect incentive to become less active with time. Although this may seem like a logical reaction to pain, it is almost certain that avoiding physical activity will make the pain become even worse over time. This knowledge comes from the unhappy experience that doctors have had in the past with prescribing prolonged bed rest and inactivity for back pain, which over time, only aggravated the situation and made it more difficult to treat in the long run. We now know that if you want to relieve the physical pain of many types of back pain while also making yourself stronger both mentally and physically, you need to get moving. A commitment to a physical conditioning program that is approved by your physician is important to everyone, but it is especially important to those with chronic back pain.
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